| PURPOSE:Lung cancer is the number one cancer killer worldwide,with small cell lung cancer accounting for 13-15% of all lung cancers.Although small cell lung cancer is highly sensitive to radiotherapy and chemotherapy,the overall survival time is still 7 to 10 months,and the average 2-year survival rate is 10 to 20%.The guidelines for the diagnosis and treatment of small cell lung cancer are very clear.There has been no fundamental breakthrough in the last 30 years,and the standardized diagnosis and treatment has basically reached the global scale.However,the situation in the real world is unknown.Many studies have explored the factors that influence the prognosis of SCLC,but data reports are inconsistent,and there is no definitive marker associated with survival.The purpose of this study was to collect data on small cell lung cancer(SCLC)to observe the survival of patients with SCLC in the real world,and to explore possible factors affecting SCLC survival.In addition,the researchers found some small cell lung cancer patients with long survival in daily life,which inspired my intreast.The second part of this study summarized the baseline characteristics and treatment-related indicators of patients with long survival,and explored the relationship between these characteristics and long survival.Method:In this study,the electronic medical record system and PACS system were used to collect the information of patients with small cell lung cancer(SCLC)treated in the department of oncology of Tianjin Medical University General Hospital.Survival information of patients was obtained through telephone follow-up and medical records query,and baseline characteristics and treatment-related indicators of patients were summarized in Excell form.Univariate analysis and multivariate survival analysis were used to find the possible indicators affecting survival.In the analysis of long-survival cases,patients who were followed up for less than 2 years but still survived were excluded.Statistical methods SPSS23.0 statistical software and Medcalc 19.1 statistical software were used.Counting data of two independent samples were tested by Chi-square test or Fisher’s exact probability test,and non-parametric test was used for those that did not meet the requirements of Chi-square test.The measurement data of two independent samples were tested by t test.The survival curve was plotted by Kaplan-Meier curve,and the survival difference was statistically analyzed by Log-rank.Logistic regression analysis and odds ratio calculation were used in univariate analysis,and Cox regression model was used in multivariate regression survival analysis.The detection level was α=0.05.Result:1.In this study,a total of 300 patients with SCLC were collected,including 108 patients with limited stage and 192 patients with extensive stage.There were no significant differences in age,sex,smoking history,mean smoking index,family history of malignancy,underlying disease history,ECOG,tumor growth site and peripheral vascular invasion(P > 0.05)between LS-SCLC(Limitied Stage-Small cell lung cancer)and ES-SCLC(Extensive Stage-Small cell lung cancer).Single factor analysis found that region of tumor growth(P = 0.004),the surrounding heart vascular invasion(P < 0.0001),first-line chemotherapy efficacy(P = 0.0202),PFS≥ 6months(P = 0.0035),chest radiotherapy(P = 0.0353)maybe a risk factor for prognosis of Limited stage small cell lung cancer survival.Cardiac vascular invasion was an independent factors of LS-SCLC prognosis factors around multivariate regression survival analysis.Single variate analysis found that region of tumor(P =0.0197),the heart vascular invasion(P = 0.0069),first-line chemotherapy efficacy(P< 0.0001),PFS≥ 6 months(P < 0.0001),chest radiotherapy(P = 0.0001),the choice of platinum in the first line(P = 0.0025),the types of recurrence(P = 0.0012),brain(P =0.0417)therapy,second-line chemotherapy(P < 0.0001)are maybe a risk factor for prognosis of Limited stage small cell lung cancer survival.Tumor location,peripheral cardio vascular invasion,first-line treatment efficacy,brain radiotherapy,and PFS≥6months were independent indicators to evaluate the prognosis of extensive stage small cell lung cancer.2.A total of 211 patients who met the requirements of the research were collected in this study,including 33 long term survivors(LTS,survival time ≥2 years)and 178 short term survivors(STS,survival time < 2 years).In terms of baseline characteristics,there were no statistical differences in age,gender,smoking history,first symptom,underlying disease,family history,ECOG score,peripheral vascular invasion and Ki-67 mean index between the two groups(P > 0.05),while there were differences in mass location,VALG stage and TNM stage between the two groups(P< 0.05).By univariate analysis,mass location,VALG stage,TNM stage,liver metastasis and adrenal metastasis were the predictors of LTS(P < 0.05).In terms of treaty-related indicators,there were no differences in first-line treatment strategy,first intervention mode,brain radiotherapy and second-line efficacy between the two groups(P > 0.05),while there were differences in chest radiotherapy,first-line efficacy,type of recurrence,second-line chemotherapy,PFS≥6 months,and mean SPP between the two groups(P < 0.05).After univariate analysis,the selection of platinum,chest radiotherapy,first-line efficacy,recurrence type,PFS≥6 months,and second-line chemotherapy were the predictors of LTS(P < 0.05).Multivariate Logistic regression analysis showed that first-line treatment efficacy was an independent predictor of LTS.Conlutions:1.Tumor mass location,surrounding heart vascular invasion,first-line treatment efficacy,chest radiotherapy,and PFS≥6 months are risk factors for prognostic outcomes of LS-SCLC,among which surrounding heart vascular invasion is an independent prognostic index.2.Tumor mass location and surrounding heart vascular invasion,first-line treatment efficacy,the choice of platinum,type of recurrence,chest radiotherapy,brai radiation,PFS≥6 months,second-line chemotherapy are risk factors for prognostic outcomes of ES-SCLC,among which the tumor mass location and heart vascular invasion,first-line treatment efficacy,brain radiotherapy,PFS ≥ 6 months are independent prognostic indicator.3.Selection of first-line platinum,chest radiotherapy,first-line efficacy,type of recurrence,PFS≥6 months,second-line chemotherapy were predictors of LTS,and first-line treatment efficacy was an independent predictor of LTS. |
PDF Full Text Request